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Comparison of three topical antimicrobials for acute bacterial conjunctivitis
J A Lohr1, R D Austin, M Grossman
1Department of Pediatrics, University of Virginia Children's Medical Center, Charlottesville.
Insights
Trimethoprim-polymyxin B (TP), gentamicin sulfate (GS), and sodium sulfacetamide (SS) ophthalmic solutions showed similar clinical and bacteriologic responses for treating bacterial conjunctivitis in pediatric patients. All treatments were effective in clearing infections caused by Haemophilus influenzae or Streptococcus pneumoniae.
Area of Science:
- Ophthalmology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Bacterial conjunctivitis is a common ocular infection in children.
- Common causative agents include Haemophilus influenzae and Streptococcus pneumoniae.
- Ophthalmic antibiotic solutions are standard treatments.
Purpose of the Study:
- To compare the efficacy of trimethoprim-polymyxin B (TP), gentamicin sulfate (GS), and sodium sulfacetamide (SS) ophthalmic solutions.
- To evaluate treatment outcomes for bacterial conjunctivitis in pediatric patients (≤21 years).
Main Methods:
- A prospective study involving 158 pediatric patients with culture-positive bacterial conjunctivitis.
- Patients were treated with TP, GS, or SS ophthalmic solutions for 10 days.
- Clinical and bacteriologic responses were assessed during and after therapy.
Main Results:
- Similar clinical cure and improvement rates were observed among TP, GS, and SS groups during therapy (47-49% cured, 45-48% improved).
- High and comparable clinical cure rates (84-89%) were noted 2-7 days post-therapy across all treatment arms.
- Bacteriologic response rates were also similar, with 68-83% of patients showing clearance of causative organisms (Haemophilus influenzae, Streptococcus pneumoniae).
Conclusions:
- Trimethoprim-polymyxin B, gentamicin sulfate, and sodium sulfacetamide ophthalmic solutions demonstrate comparable efficacy.
- These agents are effective for treating bacterial conjunctivitis caused by Haemophilus influenzae and Streptococcus pneumoniae in pediatric populations.
- Treatment choice may be guided by factors other than efficacy, such as cost or resistance patterns.
Abstract:
One hundred fifty-eight patients, 21 years of age or less, presenting with culture-positive (Haemophilus influenzae or Streptococcus pneumoniae) conjunctivitis were treated with trimethoprim-polymyxin B (TP), gentamicin sulfate (GS) or sodium sulfacetamide (SS) ophthalmic solution for 10 days. Clinical response at 3 to 6 days after start of therapy was similar for all test agents: 26 of 55 (47%) patients cured, 25 of 55 (45%) improved for TP; 28 of 57 (49%) cured, 26 of 57 (46%) improved for GS; and 19 of 46 (41%) cured, 22 of 46 (48%) improved for SS. Clinical response at 2 to 7 days after completion of therapy was also similar: 46 of 55 (84%) patients cured, 5 of 55 (9%) improved for TP; 50 of 57 (88%) cured, 5 of 57 (9%) improved for GS; and 41 of 46 (89%) cured, 2 of 46 (4%) improved for SS. Bacteriologic response at 2 to 7 days after completion of therapy was similar for all antimicrobials: 44 of 55 (83%) patients for TP; 39 of 57 (68%) for GS; and 33 of 46 (72%) for SS.